(Diverticulosis are multiple diverticula...diverticulitis is the inflammation of one or more diverticula)

congenital or acquired pouchlike herniations of mucosa through the muscular wall of small intestine or colon

Where can diverticula occur?

in any part of small or large intestine, but occur mostly in SIGMOID COLON

Define etiology?

cause of disease

Define pathophysiology?

the study of how normal physiological processes are altered by disease

Describe the pathophysiology of the formation of diverticula?

it becomes herniated...so where do diverticula seem to occur?

ha! as part of the aging process

the musculature of the colon hypertrophies, then thickens, then becomes rigid...and then what happens to the mucosa and submucosa of the colon wall?

hmmm...at points of weakness in the intestinal wall, often at areas where blood vessels interrupt muscular continuity....and how does muscle weakness develop, you in the back?

All by themselves, diverticula cause few problems. However, if _____ or ______ become trapped in a diverticulum, however, blood supply to that area _______ and bacteria invades the diverticulum. And so how does diverticulis result from there?

foodbacteria

diminishes

the diverticulum perforates and a local abscess forms....and so what can form if the perforated diverticulum progresses to intra-abdominal perforation?

What range can bleeding from diverticula occur in? (3)

minorlocalizedmassive hemorrhage

What is minor bleeding of diverticula due to?

vascular granulation...at the base of?

localized inflammation in areas of ________ ______ tissue?

diverticulum

Hemorrhage can result when a ______ _____ is eroded within a diverticulum

blood vessel

What can lead to narrowing of the bowel lumen, and resultant obstruction?

fistulas to other organs, such as bladder and vagina.

inflammation...and so inflammation can also result in ______?

What has been implicated in the development of diverticula?

diets with small amounts of fiber because they cause less bulky stool and possible constipation

What must happen for diverticulosis and diverticulitis to occur?

there must be an increase in intraluminal pressure and muscle contractions to move fecal material through the colon

What is the etiologic factor in diverticulitis?

retained undigested food in diverticula, which compromises blood supply to that area and facilitates bacterial invasion of the sac

Diverticulitis affects what percentage of adults over age 60?

one third, more men than women...only one in 5 display symptoms

Most clients are asymptomatic, and unless _____ or _____ develops, the condition may go undiagnosed or found incidentally on routine ________.

painbleeding

colonoscopy

Uncomplicated diverticulosis that causes symptoms might have ________and _________ and possible rectal _____ and INTERMITTENT pain in which part of the body?

A barium enema exam will usually not be performed in acute phase of diverticulitis because?

after the patient has been treated with antibiotics and inflammation has resolved.

there's a risk of rupture of inflamed diverticulum....so when is a barium enema done?

A CT scan may be ordered to diagnose?

an abscess or thickening of the bowel related to diverticulitis.

Ultrasonography, noninvasive, may reveal?

bowel thickening or an abscess

The doctor may perform a _________ or ________ after the ACUTE PHASE of the illness, usually to rule out presence of tumor in large intestine, particularly if patient has rectal bleeding...there is a risk for perforation.

sigmoidoscopycolonoscopy

If symptoms are mild, patient may be treated outpatient. This would be done if temp is lower than _____ and WBC ranges from ______ to _________.

Monitor patient for prolonged or increased _____,__________, or _______ in stool.

101

13,000 to 15,000/mm3

feverabdominal painblood

Nonsurgical management is a combination of ______ and _____ therapy with rest to decrease inflammation and improve tissue perfusion. Start antibiotics, such as?

because they're IRRITATING!BUT!...as diverticulitis resolves, fiber can be gradually added until progression to a high-fiber diet is once again obtained. This could happen

diverticulitis because why?

What should the nurse instruct the patient to do at some point following discharge from the hospital for diverticular disease?

1 month FU visit to HCPrepeat flexible sigmoidoscopy or barium enema can be performed at that timeif patient had surgery, then give instructions on incision care and signs and symptoms to report to HCPprovide instruction on colostomy care if received

What are the manifestations of acute diverticular disease?

feverabdominal painbloody, mahogany, or tarry stoolsavoid laxatives other than bulk-forming onesavoid activities that increase intra-abdominal pressure, such as straining at stool, bending, or lifting heavy objectscan be resolved with proper dietdoesn't commonly recur if everything done rightdiscuss alteration of body image and loss of body function